Utilizing a publicly available, evidence-based virtual reality application for patients undergoing office-based urological procedures: A randomized feasibility trial

PURPOSE: Pain and anxiety are often experienced by patients during awake surgeries involving local anesthetics including urological procedures. Virtual reality (VR) shows promise in reducing both perioperative pain and anxiety, however, research on VR use during urological procedures is limited. OBJECTIVES: Assess the feasibility (i.e., recruitment, retention, and acceptability) and pilot outcomes (i.e., distress, anxiety, and pain) of an evidence-based, publicly available VR intervention delivered perioperatively during vasectomies and cystoscopies. METHODS: Patients were recruited from a men's health clinic in central Canada. Participants were randomized to either a VR relaxation intervention (Tripp software), or treatment-as-usual (TAU). Self-reported pain, distress, and anxiety questionnaires were administered throughout the perioperative period. Feasibility and pilot outcomes were collected throughout the study and evaluated descriptively through mean comparisons, and with a content analysis for open-ended questions. RESULTS: Over half of participants screened enrolled (N = 42 enrolled; n = 30 for vasectomies). Differences in recruitment according to surgery were observed, with 46.15% (cystoscopy) and 66.00% (vasectomy) of patients agreeing to participate, respectively. The data completion rate was 97.60%. Most enjoyed the VR intervention and found it helpful. No significant anxiety and distress differences emerged between intervention groups overall, though positive trends were observed for the use of VR for distress. The VR group for vasectomies had significantly lower intraoperative pain (t = 1.93, p < 0.05) compared to TAU. CONCLUSIONS: Results suggest greater feasibility for the use of VR for vasectomies, compared to cystoscopies, due to the much shorter procedure time and lower interest among cystoscopy patients. Preliminary trends suggest benefits of VR for intraoperative pain and distress. Future adequately powered randomized controlled trials are warranted.